This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Thursday, October 30, 2014

Review Of The Ongoing Post - Budget Controversy 30th October 2014. No Sign Of Stopping!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.

It is amazing how the discussion on the GP Co-Payment just runs and runs. Some more this week.

Here are some of the more interesting articles I have spotted this 22nd week since it was released.

Clearly Ebola and the Government Response and the new Primary Health Networks got a lot of coverage and this continues.

The House of Reps returned a week or so ago and the Senate comes back 27th October so we will see how we go! I note rumblings about a much different approach to the Budget in 2015!

AUSTRALIA must repair the federal budget and confront global risks, including falling commodity prices, according to a new alert from the Parliamentary Budget Office that sharpens the political fight over controversial savings.

But he warned that disputes in the upper house threatened to weigh down the budget by about $18 billion a year by 2024, undermining the government’s plan to deliver a surplus of about 1.4 per cent of gross domestic product in that year.

Although this week’s Senate estimates hearings make it impossible for the upper house to vote on budget bills this week, ministers are stepping up talks with crossbenchers on key savings in the hope of securing some changes before the end of the year.

Oh dear, what an embarrassment. Thank heavens so few journalists noticed. Last month one of the federal government's official beancounters, the Australian Institute of Health and Welfare, issued its report on total spending on health in 2012-13. It didn't exactly fit with what the government has been telling us.

As you recall, the minister for Health, Peter Dutton, got an early start this year, warning that health spending was growing "unsustainably". (Blame it all on Gough Whitlam, whose supposedly too expensive Medibank Malcolm Fraser dismantled, only to have Bob Hawke restore it as Medicare.)

The report of the Commission of Audit soon confirmed that health was prominent among the various classes of government spending growing - and projected to continue growing - "unsustainably".

The Abbott government’s “Operation Budget Repair” appears to have morphed into “Operation Let’s Salvage What The Hell We Can”.

The social security minister, Kevin Andrews, said this week he would consider “any reasonable offer” from crossbench senators in a last-ditch bid to get at least some of his $10bn in stalled welfare changes through the Senate.

And another $10bn or so of proposed savings or revenue raisings also remain on the Senate scrap heap, including the reindexation of fuel excise, the Medicare co-payment and the dramatic changes to higher education.

Medibank Private Sale.

Elizabeth Savage

Professor of Health Economics at University of Technology, Sydney

The IPO of Medibank Private is set to take place on November 25, and the indicative share price range in the prospectus released today suggests a market capitalisation of between A$4.3 billion and A$5.5 billion.

In public hands, Medibank has paid dividends of about A$450 million to the government over the past two years.

There are mixed opinions on whether the privatisation of Medibank will be largely positive or negative. However, from the point of view of Australian society overall, the privatisation is a good decision financially only if the revenue from the sale compensates for the loss of future returns.

Key points

Orthopaedic surgeon John Tuffley says Medibank Private is risking patient health and putting pressure on the ­public system by refusing to pay for what it argues are avoidable revisions of ­surgeries such as hip and knee replacements. Medibank has already struck a deal with private hospital group HealtheCare, which means the insurer does not have to pay if a surgery goes wrong and needs to be revised within 28 days of the original event.

The insurer’s managing director George Savvides has said the market leading insurer pays $100 million for revisions each year. Although he concedes that not all are avoidable, he wants to reduce that cost.

Senior writer

John Menadue still carries a sharp image in his head of the night in Melbourne, 47 years ago, when Medibank began crystallising as an idea for Labor.

It was a crisp July winter's evening in Kew, and gathered around a log fire at the home of left-leaning medico, Dr Moss Cass, were then opposition leader Gough Whitlam, Menadue (at that time Whitlam's aide), Cass and two health economists who'd become the architects of Australia's universal health care system, Dr John Deeble and Dick Scotton.

Deeble and Scotton had been researching ways to make health insurance - then voluntary and fragmented - more readily available and affordable to the great mass of Australians.

EXCLUSIVE: If you want obesity surgery, neurosurgery, cardiac surgery or a hip replacement you’re now likely to have to buy top private health cover, as insurers introduce a de facto risk rating system.

Patients who want comprehensive health cover now have to pay thousands of dollars more than they did in the past — or use the public system.

Australia’s private insurance is meant to be community rated, and no matter how sick you are you pay the same premium as a healthy person.

However, doctors say that by shaving some key procedures from cheaper policies, insurers are sneaking in a risk-rated system where your premium is determined by your health status.

PRIME Minister Tony Abbott has raised concerns about the potential spread of ebola to our region with the Papua New Guinea government, insisting that countries in the region be prepared for the killer virus.

The PM stopped in PNG on his way to Jakarta yesterday for the inauguration of Indonesian President Joko Widodo.

According to senior government sources, Mr Abbott met PNG Prime Minister Peter O’Neill to discuss “the global response to ebola and the importance of preparedness in the region”.

AUSTRALIAN medical teams lack specialist training to manage an Ebola epidemic in our region, despite government claims it could “rapidly deploy forces” to a neighbouring country if requested.

The revelations that Australian Medical Assistance Teams were not being provided the training, which can take weeks, came as a leading public health expert said there was a “quite high” risk of isolated Ebola outbreaks in Australia, although such cases would be managed “very well”.

The Abbott government has resisted opposition calls to deploy medical personnel to combat the West African epidemic, warning of the difficulties in evacuating Australians infected with the virus.

AUSTRALIA may not be ready to fully respond to an Ebola outbreak in our wider region, and it could be more than two weeks before all the response teams are prepared, a Senate Estimates hearing has heard.

The information from the nation's chief medical officer comes only days after he said state and territory health authorities were ready for an Ebola outbreak.

Professor Chris Baggoley told the hearing on Wednesday the rapid-response Australian Medical Assistance Teams had not received the right training.

Matthew Knott, Latika Bourke, Lisa Visentin

The peak medical body has accused the Abbott government of acting too slowly to tackle the Ebola crisis because of concerns about the political consequences of an Australian health worker being infected with the disease.

Government sources played down reports that Australia would be sending up to 16 health workers to west Africa as early as next week to fight the outbreak, but said negotiations with Britain to provide medical assistance were advancing.

It was confirmed on Friday that a doctor in New York had tested positive for the virus – the city's first diagnosed case.

GP Co-Payment.

GP co-payment could strip benefit of Base Hospital upgrade

LISMORE Base Hospital's $80 million new emergency department will be twice as big as the present ED, but it will struggle to cope with the impact of the federal government's proposed $15 GP co-payment, according to a local nurse.

It's widely predicted that people with chronic disease, the elderly and others struggling to make ends meet are likely to visit hospital instead of seeing their GP because of the payment, which will charge $15 per GP visit, and $7.50 for concession card holders.

Now, figures from the a briefing prepared for NSW Premier Mike Baird (just released by NSW Labor) have put more science into that sentiment, predicting the co-payment will push up emergency department visits across NSW by 27%.

Emergency arrivals to jump under co-payment: Labor

The Labor candidate for the far west says the proposed GP co-payment would flood Broken Hill hospital's emergency department with an extra 5000 patients a year.

Labor says New South Wales Health modelling predicts that the Coalition's proposed $7 co-payment, if introduced, would result in a 27 per cent increase in the number of patients presenting to emergency rooms across the state.

RURAL towns will have better chances of recruiting doctors under major changes to an unfair and controversial government incentive system.

Assistant Minister for Health Fiona Nash, who has championed the need to improve access to health services for people living in rural areas. is expected to announce the changes soon.

The outcome is a major victory for The Sunday Telegraph, which has been campaigning to improve the poor health systems in the bush that see country residents die up to three years earlier than city people.

Pharmacy Related Articles.

The Pharmacy Guild of Australia has officially launched a new consumer campaign, featuring a series of online and television advertisements.

The multi-media campaign is part of the Guild’s bid to advance community knowledge of the value of local pharmacies.

On Sunday night, an animated television advertisement was first aired across Australia, and will continue for the next six weeks. It will then be shown again early next year, until the end of February.

Even doctors taking part in a pharmacy skin cancer check service have doubts about its accuracy and efficacy, a senior AMA official claims.

As previously reported, AMA NSW president Dr Saxon Smith publically criticised the ‘Spotcheck’ service offered by Guardian, Amcal and Chemmart pharmacies, and said they were not suitable locations for identifying skin cancers.

The screening service involves pharmacy staff photographing a spot, with the images then forwarded to doctors working at Sunspot skin cancer clinics for further analysis.

Responding further on the Pharmacy News website, Dr Smith said the concerns he voiced about the service were raised purely because of the potential for missed, inaccurate or wrong diagnoses.

THE federal government is targeting the last great bastion of health bureaucracy, launching a review of the “thicket” of red tape around the drugs and medical ­devices available to Australians.

With the cost-cutting proposals of its first budget still subject to political negotiations, the government has seized the opportunity to examine whether the Therapeutic Goods Administration should be allowed to fast-track approvals or reduce the regulatory burden on manufacturers.

Former Pharmaceutical Benefits Advisory Committee chairman Lloyd Sansom will spearhead a review, supported by former chief medical officer John Horvath and former Medicines Australia chairman Will Delaat.

But Primary, an ASX-listed company with 87 medical centres, is unhappy with the government's choice of the words "Primary Health", which it believes could confuse the public's perception of its 25-year-old brand.

By NIGEL MCNAY

A BATTLE to keep Albury and Wodonga in the same primary healthcare region will be taken to Canberra next week.

Indi MP Cathy McGowan is pushing for a meeting between the Hume Medicare Local board and Health Minister Peter Dutton.

Hume Medicare Local is funded only until mid-next year.

After then, it and other Medicare Locals across Australia will be replaced by what the government has dubbed Primary Health Networks.

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Comment:

I also have to say reading all the articles I still have no idea what is actually going to happen with the Budget at the end of the day. Maybe the next few weeks of parliament will clarify things this time but I doubt it.

To remind readers there is also a great deal of useful health discussion here from The Conversation.

1 comment:

http://www.smh.com.au/comment/health-spending-crisis-isnt-real-20141021-1196j8.html Health spending crisis isn't real. Ross GittinsDavid, in response to the article by Ross Gittins and his referencing of Stephen Duckett I would like to make the following comments.The “non-sustainability” of health care spending may appear to be a misnomer and as “numbers” people economists can put their interpretations on the graphs and statistics to justify their perspectives. Despite these “authoritative” views there are other opinions.Health in Australia compared to other OECD countries (excluding the USA) is equally as expensive and within these “advanced economies” there is much waste (underuse, overuse and inappropriate use) of resources.Publications from the Dartmouth Institute on Medicaid/Medicare populations in the USA provide suitable comparisons with care costs and quality to other OECD countries.Also within our Australian so-called “best health care system in the world” there is much poor quality and costly care. There is also significant inappropriate variation in care and poor measures of care delivery due to the questionable value of the exiting data measures. In all these discussions the patient remains at the centre and we know that the current system is currently unable to correct and prevent patient harm and poor quality outcomes. In fact it has been stated that our current health insurance systems “pay for the costs of correction” of poor quality outcomes because we cannot “see” them nor prevent them. So there is “unsustainability” in the Australian health care system because many of the costs and poor quality are preventable.